Granulocytic sarcoma of the oral cavity in a chronic myeloid leukemia patient: an unusual presentation.

Intraoral granulocytic sarcoma is an unusual manifestation of chronic or acute leukemia. The oral manifestations often involve enlargements of the gingival and mucosal tissue from direct leukemic cell infiltration. Only 38 cases have been reported in scientific literature to date. We present the case of a 47 year-old female who was diagnosed with chronic myeloid leukemia (CML) in December 2006. She was referred to a dentist for further evaluation, revealing generalized gingival overgrowth as well as periodontal, apical disease, and bleeding of the gums. An oral biopsy was performed and histological features revealed immature blast-like cells.

Oral manifestations after immune reconstitution in HIV patients on HAART.

In order to verify possible association between immune reconstitution inflammatory syndrome (IRIS) and oral manifestations (OMs), we selected AIDS patients who had low CD4 count before the initiation of highly active antiretroviral therapy (HAART) and who returned three months later for therapy evaluation. The oral lesions observed three months after the initiation of HAART were evaluated and associated with the type of antiretroviral therapy (ART), CD4 count and HIV-RNA load levels (before and three months after HAART initiation). A total of 105 patients matched the selected criteria. Immune reconstitution (IR) was identified in 35.2%. Among these patients, the mean CD4 cell count rose from 105.97 to 330.29 and the mean viral load dropped from 168.005 (log 5.22) to 21.852 (log 4.33). There was no significant difference in age (P = 0.78), sex (P = 0.41) or previous history of ART (P = 0.55) between IR and non-IR patients. In the IR group, the most common OM was parotid enlargement (57.14%) (P = 0.019), whereas in the non-IR group candidiasis (46.15%) was the most common OM. The results of our study suggest that the parotid gland enlargement found in the studied population might be an IRIS event, as it was found in patients with IR three months after the initiation of HAART.

Recessive dystrophic epidermolysis bullosa--oral rehabilitation using stereolithography and immediate endosseous implants.

Dental management of patients with epi-dermolysis bullosa (EB) is challenging because of the severe soft tissue lesions associated with this disease. A case history is presented where two immediate endosseous implants were placed in the mandible of a patient with recessive dystrophic EB using computer-aided technology to plan the surgery and prosthetic rehabilitation. After a 24-month follow-up, the prosthesis was stable with healthy asymptomatic soft tissue around the implants. The stereolithographic model provides a precise and noninvasive copy of the mandibular and maxillary arches of patients with EB for rehabilitation of the dentition with immediate endosseous implants and a prosthesis.

Granulocytic sarcoma of the oral cavity in a chronic myeloid leukemia patient: An unusual presentation

Intraoral granulocytic sarcoma is an unusual manifestation of chronic or acute leukemia. The oral manifestationsoften involve enlargements of the gingival and mucosal tissue from direct leukemic cell infiltration. Only 38 caseshave been reported in scientific literature to date. We present the case of a 47 year-old female who was diagnosedwith chronic myeloid leukemia (CML) in December 2006. She was referred to a dentist for further evaluation,revealing generalized gingival overgrowth as well as periodontal, apical disease, and bleeding of the gums. Anoral biopsy was performed and histological features revealed immature blast-like cells (AU)